Organization Active NPI

Tacoma Foot and Ankle Clinic Inc

  • Foot & Ankle Surgery Podiatrist
  • Tacoma, WA
National Provider Identifier
1144481557
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO00000782 Issued in WA
Legal business name
TACOMA FOOT AND ANKLE CLINIC INC
Practice address
1206 S 11TH St
Suite 2
Tacoma, WA 98405-4090
Phone
(253) 272-0606
Fax
(253) 272-2118
NPI assigned
Jun 18, 2008
Last updated
Jun 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ha Quang Nguyen, DPMNPI 1508825449
Title
Owner
Phone
(253) 272-0606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO00000782 WA Primary

Addresses

Primary practice location

1206 S 11TH St
Suite 2
Tacoma, WA 98405-4090

Mailing address

1206 S 11TH St
Suite 2
Tacoma, WA 98405-4090
Phone (253) 272-0606

Other identifiers 1

IdentifierTypeStateIssuer
1122399MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080828000151 WA Part B Supplier - Clinic/Group Practice 4486720455 Receives reassigned benefits from 1 practitioner
Practice locations: Tacoma, WA

National Provider Directory

National Provider Directory

Locations

1206 S 11th St
Ste 2
Tacoma, WA 98405
Phone (253) 272-0606

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1144481557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 S 11TH ST",
            "address_2": "SUITE 2",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054090",
            "telephone_number": "253-272-0606",
            "fax_number": "253-272-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 S 11TH ST",
            "address_2": "SUITE 2",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054090",
            "telephone_number": "253-272-0606",
            "fax_number": "253-272-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TACOMA FOOT AND ANKLE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "HA",
        "authorized_official_middle_name": "QUANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-272-0606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO00000782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1122399",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.